online claims entry adjustment, void and re-bill · 2017-12-29 · online claims entry adjustment,...
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Online Claims Entry Adjustment, Void and Re-bill
Conduent
Government Healthcare Solutions
11/09/2017
Resources
When online use: Ask Service Representative
Call Center 800-299-7304
New Mexico Web Portal
• Provider Information section
• Links and FAQ section
• Provider Login section
Important State Websites
10/9/2017 Family Planning Workshop
STATE WEBSITE:
PROGRAM POLICY MANUAL
• http://www.hsd.state.nm.us/mad/policymanual.html
BILLING INSTRUCTIONS
• http://www.hsd.state.nm.us/mad/billinginstructions.html
REGISTERS AND SUPPLEMENTS:
• http://www.hsd.state.nm.us/mad/registers/2012.html
Adjustments
10/9/2017 Family Planning Workshop
• A paid claim can be adjusted.
• Providers CAN NOT adjust a denied claim.
• ONLY Claims that have been processed through Online Claims Entry can be adjusted online. Claims processedthrough EDI or on paper CAN NOT be adjusted on the web portal.
• Attach any new attachments pertinent to the adjustment.
Adjustments – Filing Limit
10/9/2017 Family Planning Workshop
Adjustments must be submitted within 90 days from the date on the RA, for the paid claim.
Submitting an Adjustment
Conduent
Government Healthcare Solutions
Adjustments
Adjustments
CMS- 1500 Adjustment Form
CMS- 1500 Adjustment Form
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information providedTo add additional line items, select “Add Service Line
Item”
Select “Edit” to make changes to lines already populated.
CMS- 1500 Adjustment Form
CMS- 1500 Adjustment Form
UB-04 Adjustments
Conduent
Government Healthcare Solutions
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information providedTo add additional line items, select “Add Service Line
Items”
Select “Edit” to make changes to lines already populated.
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
UB-04 Adjustments
September 1, 2020 Adjustment, Void, and Claim Rebill Online Entry Workshop
All data associated with the
previously submitted TCN will
auto-populate
Make any changes to the existing
information provided
X
Once adjusted claim is submitted,
a new TCN will be generated.
UB-04 Adjustments
September 1, 2020
Adjustments – Filing Guidelines Recap
Adjustment, Void, and Claim Rebill Online Entry Workshop
• Make any changes to the existing information provided on the
previously submitted TCN. Only make changes to data that will
impact the adjustment.
• Indicate Timely Filing Justification TCN number provided in the claim information section.
Submitting a Void
Conduent
Government Healthcare SolutionsSeptember 1, 2020Adjustment, Void, and Claim Rebill Online Entry Workshop
Adjustment, Void, and Claim Rebill Online Entry WorkshopSeptember 1, 2020
Void Request
Enter The Recipient ID, TCN, Action, & Void Reason
Adjustment, Void, and Claim Rebill Online Entry WorkshopSeptember 1, 2020
Void Request
Adjustment, Void, and Claim Rebill Online Entry WorkshopSeptember 1, 2020
Void Request
Claims Re-bill
Conduent
Government Healthcare Solutions
Adjustment, Void, and Claim Rebill Online Entry WorkshopSeptember 1, 2020
Claims Re-bill
Conduent
Government Healthcare Solutions
What Questions Do You Have?
What take away message do you
have to share with us?
11/09/2017
Resources
When online use: Ask Service Representative
Call Center 800-299-7304
New Mexico Web Portal
• Provider Information section
• Links and FAQ section
• Provider Login section
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